Carolina Mestas: CrossFit, physical therapy and working in a US hospital in times of Covid-19

With a life that seems to be marked by physical exercise, today, at thirty years old, Carolina Mestas uses all her knowledge to help people move and walk again; certainly, activities that most of us take for granted. On her back, ten years of competitive gymnastics and other ten of CrossFit training, this last one being the one that has allowed her to keep in shape and, curiously, also helped her doing her job with her patients. Because, even if it doesn’t look that way, being a physical therapist in a US hospital is not easy and much less in times of pandemic. In this new Matias Dice Blog interview (also available in Spanish), we talked with… my cousin.

 

Along with Brazil, the United States is currently one of the most affected countries due to the coronavirus pandemic, which continues to expand having already surpassed one million infections. In this last month, particularly in the city of San Antonio, TX, the transmission of this infamous virus has resurfaced with hundreds of new infections per day, and a 700% increase in hospitalizations for Covid-19. According to the San Antonio Express News, last Friday, one in every five local hospital admissions were coronavirus cases. In one of these hospitals is were Carolina Mestas, Doctor in Physical Therapy (DPT) for the University of Texas, works.

 

As a biology major, Carolina always had an inclination for medicine, something that runs in the family. However, in the United States, patient care is not as personalized as in, for example, Argentina; and she wanted to spend more than five minutes with her patients. Almost by chance, through an university program, she discovered the work of physical therapists, something that fit perfectly with her passion for exercise. “When I went into the clinic and saw that they spent from thirty minutes to an hour with a patient, I realized that was what I wanted to do, I wanted to spend time with a patient, exercising or encouraging; because, for me, more than the physical component, is walking them through something mental”, she explained.

 

Matias Dice (MD): What do you like the most about your job?

Carolina Mestas (CM): My passion, which is surprising because I never thought it would be the case, is that I love geriatrics, which is working with older people. I went into PT school thinking that I wanted to do sports medicine, which is what 75% of the class wants to do. The last specialty I thought I would enjoy was geriatrics; but there is just something about it, their stories, what motivates them, their attitude… It’s crazy, but it’s my favorite.

 

For most of her patients, PT stands for Pain and Torture. 

In this way, working with her patients became her mission. Something that goes far beyond a simple professional obligation. “I like to make it more like ‘we are doing this together’ rather than ‘I’m just trying to get you up because it is my job’; in fact, I spend a lot of time showing them that I care and talking with their families, telling them that all the effort they are doing is for them”, said Carolina. “I believe it is very important to set that tone from the beginning, to kind of get them in the same page, because, if not, it’s just not gonna happen”.

 

Physical therapy in times of pandemic

 

With the scourge of Covid-19, at the beginning, and the following hospital prohibition of visitors, the motivational factor of having patient’s family members there became a little bit complicated. “I started just grasping straws, I used Face Time or Skype to call their families, I didn’t even know where to start… How am I supposed to motivate this person, specially when I could see them getting depressed? It was rough”, she said. “No one told us we had to do that, it wasn’t our job, but I really felt that the only motivation for those people was getting in touch with their families; so, I did that”. Now, at least, one visitor per patient is allowed but with restricted hours. Nevertheless, what she learned out of this situation was the great role family plays in the rehabilitation of a patient.  

 

MD: What kind of equipment do you guys have at the hospital?

CM: It started off with everybody needing to wear an N95 mask, which protects you against airborne droplets. But there’s been a shortage nationwide for equipment so, at our hospital, we ended up saving those for people who were actually dealing with Covid patients. Instead, we got the surgical masks that we were all so skeptical of, and we were actually having to use the same mask even for two days in a row. Now, we’re a little bit better and I feel safer at my hospital but, still, I hope we can get the equipment that we need in order for us to feel safe and for our patients to feel safe.

 

MD: Did you feel afraid at some point?

CM: Originally, I did, when it all started. But more than scared for me, I was scared for my patients, because most of them are 65 and older. There were rules to follow and I wasn’t mad about them because, in my mind, if I were to do something that would put my patient at compromise, I would be devastated. So, that was my main fear. I didn’t care about me. I did feel more afraid for my husband than I did for myself. For me, I signed up to be in the medical field. Of course, I didn’t think something like this was going to happen but I know my patients come first. So, I’m less afraid now but I’m always in the back of my mind thinking that if I don’t put my mask on or if I don’t stay away from large crowds, I’m gonna be putting my patients at risk. That’s why I continue, even if rules change, on the side of caution rather than go crazy, because then it would be my fault.

 

Two weeks, no work

 

As it seemed to be the case all around the world, during the first weeks of the pandemic no one was sure of anything. And Carolina’s job situation was no different. At the beginning, her side of the hospital (for elective surgeries) was shut down because they limited surgeries to life or death situations. However, they assigned her to the part of the hospital that kept on working and she had to deal with patients with conditions that were different to the ones she was used to. From working with old people with fractures she went on to treat people that have had heart attacks or strokes. Something that was a challenge for her and that required her, once she returned home every night, to sit down and study.

Curiously, as all the PT staff was concentrated in one section of the hospital, they ended up being overstaffed. Thus, authorities decided to let go 50% of the employees, telling them that they would go back to work three months later. “It was a shock at first, because, being in the medical field, I never thought that I wouldn’t be needed”, said Carolina. “It almost felt to me like somebody died; suddenly, I’m not going to work, I’m not needed, something I studied for seven years is now gone… it took me a week to get over it, I cried, I was frustrated”.

 

Nevertheless, she knew that she was going to go back, eventually. And, though she had a lot of time to spare, she decided to use those hours to train, read and study. But, unexpectedly, only two weeks after being sent home, she got a phone call from the hospital. They needed her back, effective immediately.

 

MD: Why the sudden change?

CM: They had an influx of patients and our governor decided that elective surgeries were allowed to happen now. So, they opened my side of the hospital and the people that were left were being overworked, that’s why they called us back. Actually, they still have people that are at home that haven’t been called back yet, though the people that are there working are working overtime. Yeah, we went from no patients, to overstaffed, then got sent home, and now I’m back at work and I’m working a lot.

 

MD: How was it going back to work after those two weeks at home and in the middle of this pandemic?

CM: That first week was shocking. It was almost like an out-of-body experience. Most of all, I remember my patients’ response. They were all so thankful because they needed surgery, they were in pain, and their surgery had been put on hold. The amount of gratitude from them was awesome. Usually, in normal situations, when they open their eyes from surgery I get the ‘Oh, are you kidding?’, but this time I got thanked so much for working through this.

“I love what I do”, she added. “It takes a lot of setting aside your feelings  when you enter a room, wearing a mask, screaming through it because some of them can’t hear very well, I even learnt how to use gestures; it’s hard, it’s different, but it’s not their fault and they are so thankful that for me it’s worth it, all the stress and the fear”.

 

After this, Carolina said that, as their patients do not have the chance to receive many visitors, she takes the opportunity to spend more time with them, because she knows they are lonely.

 

Physical Therapy and CrossFit

 

In the midst of these atypical days, Carolina wakes up at 5.40am, because she knows exactly when to get up in order to get to her CrossFit gym on time (a gym that reopened after the quarantine). She trains from 6 to 7.30am, goes back home, eats something and she’s off to work. Before the pandemic she worked 8 hour shifts, now she’s doing 10 hours. After that, at like 8pm, she goes home and between 9 and 9.30pm she’s already sleeping. That’s the routine.

 

You may be wondering now what’s the connection between CrossFit and her work as a physical therapist. The answer to that starts with what they call ‘Post-Op Day Zero’. “There is a lot of research that shows that starting to work with patients on the day of surgery has the best outcomes”, she said. “They come up to the floor, we give them one or two hours to rest and then, from the moment they open their eyes, I’m like ‘Hi, I am your physical therapist, we are here to get you up’”. Now you are starting to understand where does CrossFit fit into the equation. Right?

However, not everything is as easy as it looks. For most of her patients, PT stands for Pain and Torture. “Yes, they all make the same exact joke; they come up to the floor right out of surgery, with knee replacement, shoulder replacement, some of them have fractures from a fall… and it is my job to make them stronger so that they can go home”, she pointed out.

 

And in that Day Zero of torture, of coming out of the operating room and already have someone making them do exercises and move, it’s quite easy to see why most of these 65-year-old-or-more people don’t like the idea at all. Some of them even have Alzheimer’s or dementia. “That to me is a challenge and no matter how much they don’t wanna get up, I’m like ‘let’s do it’; so, in that aspect, CrossFit has helped me a lot and it is the reason why I try to lift heavy”, she explained. “Because, sometimes, I have patients that kind of fight me, and they weigh 250 pounds, and I have to get them out of bed by myself”.

 

MD: But… why CrossFit in the first place?

CM: I like CrossFit only because of the gymnastics component. CrossFit has a lot of it, the rings, bars, I didn’t wanna try something that I didn’t feel I could sustain. So, I tried running, yoga, pilates, and I could never stick to anything. I found about CrossFit because my friends from gymnastics had tried it and they were posting videos about it. And I was like, ‘ok, handstands, I can do that’. That’s when I decided to try. Because of my friends.

 

Carolina did competitive gymnastics from when she was 5 years old up until she turned 15. Afterwards, she didn’t do anything sports related because ‘after quitting something so competitive and in which everything follows a structure, I realized I didn’t know how to exercise by myself’. Her true passion for exercise started in Dallas, back in 2011, when she discovered CrossFit, a discipline that wasn’t a big deal yet. And with that, the competitiveness and obsession to push her own limits.

 

MD: What does CrossFit mean to you?

CM: More than anything, the reason why I stick to CrossFit is the community of people. Because in your class it’s the same people day in and day out. Even during the whole sheltering, we had Zoom calls, people reaching out. For me, it’s that. It’s my place of life, my community. I like that competitive drive that you get, I like how they make the program for you. I feel like I get my money’s worth when it comes to CrossFit. Something that, maybe, doesn’t happen with other kind of gyms.

MD: How did you manage to make that switch from not doing anything to starting CrossFit and achieving that beast mode that you are at?

CM: What I say to people that I train is that ‘the moment when you go from zero to a hundred is hard to sustain’. I started off with 2-3 times a week. And then I felt that my diet needed to change. They were little changes and I’m glad I did it that way. When I started CrossFit I couldn’t even run a mile, so it has been slow and steady. In the end, the same principles that I used for my personal training in CrossFit are the ones I use now with my patients. It’s a really slow and steady process and it does not happen overnight.

 

Apart from the physical aspect of it, through the personal discipline that this activity gave her, Carolina affirms to have learned also to control her mind in “the fact that when I set myself to something I can push myself without somebody pushing me”. A technique without which, according to her, she would not have been able to compete in the Olympic triathlon she ran last year. “It’s kind of a mental thing, once my body says I’m doing something now, I make everything possible to get it done”, she said.

 

Truly, and I don’t say it because she’s my cousin, the city of San Antonio is very lucky to have a physical therapist who’s also, in the best sense of it, a CrossFit beast. And, for everybody’s sake, we hope that the situation over there gets better soon and they can all go back to the so called ‘new normal’.

 

But, we couldn’t end this interview without our obvious question. I confess that, this time, I was gladly surprised because I didn’t know anything about it. As you know, this blog has a lot to do with books and literature. Thus, our last question almost always is about that.

 

MD: Do you have any favorite book, novel or author?

CM: I don’t know if you know but all the books that I read are related to the Holocaust. For example, I love ‘The tattooist of Auschwitz’. I also love one that it’s about three older ladies and it goes through their lives during the Holocaust. I think I like that one so much because I work with old people. It’s literally all I read. It’s called ‘Lilac girls’, by Martha Hall Kelly.

 

*Important update: I did this interview at the beginning of June. Today, starting July, as I said before, the situation has become critical again in San Antonio, TX. Maybe even worse than before, because in the hospital they told PTs to get ready to start working with Covid patients, in order to improve their endurance and strength. “Just preparing for the worst”, commented Carolina, days before this being published.    

You can also click here to read this interview in Spanish!